Skip to main content

Table 2 Score for each histological finding for the generation of histological grade for the DCIS classification systems: Holland, Van Nuys and modified Black nuclear grade system

From: Histopathological grading of breast ductal carcinoma In Situ: validation of a web-based survey through intra-observer reproducibility analysis

Holland Van Nuys Modified black nuclear grade system
G1 if final score <6 G1 if final score <50 G1 if final score <6
(1) monomorphic nuclei of uniform size, regular outline and spacing (10) Nuclei 1.5 -2 RBC diameter or nuclear size in relation to normal duct: 2 fold variation in nuclear diameter (1) monomorphic nuclei of uniform size, regular outline and spacing
  or  
(1) uniform, fine chromatin (1) Nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement (1) Nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement
(1) no nucleoli (10) fine to coarse chromatin (1) uniform, fine chromatin
  or  
(1) no mitoses (1) uniform, fine chromatin (1) no nucleoli
(1) all the cells have a well-defined apex and show polarization (2) nucleoli insignificant (1) no mitoses
  or  
(1) no nucleoli
(10) any confluent necrosis
or
(1) no necrosis
G2 if final score >5 and <90 G2 if final score >1000 and <1030 G2 if final score >5 and <90 or >13 and <16 if no mitoses
(10) nuclei showing some variation in nuclear size, outline and spacing (10) Nuclei 1.5 -2 RBC diameter or nuclear size in relation to normal duct: 2 fold variation in nuclear diameter (10) nuclei showing some variation in nuclear size, outline and spacing
or or or
(1) monomorphic nuclei of uniform size, regular outline and spacing (1) Nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement (1) monomorphic nuclei of uniform size, regular outline and spacing
(10) fine to coarse chromatin (10) fine to coarse chromatin (10) nuclei 1.5 -2 RBC diameter or nuclear size in relation to normal duct: 2 fold variation in nuclear diameter
or or or
(1) uniform, fine chromatin (1) uniform, fine chromatin (1) nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement
(2) nucleoli insignificant) (2) nucleoli insignificant (10) fine to coarse chromatin
or or or
(1) no nucleoli (1) no nucleoli (1) uniform, fine chromatin
(10) mitoses present (1000) proeminent central necrosis - comedonecrosis (2) nucleoli insignificant
or   or
(1) absent   (1) no nucleoli
(10) polarization present but not pronouced   (1) no mitoses
or   
(1) all the cells have a well-defined apex and show polarization
G3 if final score >95 G3 if final score >100 and <320 or >1100 G3 if final score >95 or >13 and <16 if mitoses are present
(100) pleomorphic nuclei, anisonucleosis, usually but not always large (100) nuclei >2 RBC diameter or nuclear size in relation to normal duc: 3 fold variation in nuclear diameter (100) pleomorphic nuclei, anisonucleosis, usually but not always large
or or or
(10) nuclei showing some variation in nuclear size, outline and spacing (10) nuclei 1.5 -2 RBC diameter or nuclear size in relation to normal duct: 2 fold variation in nuclear diameter (10) nuclei showing some variation in nuclear size, outline and spacing
or or or
(1) monomorphic nuclei of uniform size, regular outline and spacing (1) nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement (1) monomorphic nuclei of uniform size, regular outline and spacing
(100) coarse, clumped chromatin (100) coarse, clumped chromatin (100) nuclei >2 RBC diameter or nuclear size in relation to normal duc: 3 fold variation in nuclear diameter
or or or
(10) fine to coarse chromatin (10) fine to coarse chromatin (10) nuclei 1.5 -2 RBC diameter or nuclear size in relation to normal duct: 2 fold variation in nuclear diameter
or or or
(1) uniform, fine chromatin (1) uniform, fine chromatin (1) nuclei 1-1.5 RBC diameter or nuclear size in relation to normal duct: similar, minimal enlargement
(10) evident nucleoli (10) evident nucleoli (100) coarse, clumped chromatin
or or or
(2) nucleoli insignificant (2) nucleoli insignificant (10) fine to coarse chromatin
or or or
(1) no nucleoli (1) no nucleoli (1) uniform, fine chromatin
(10) mitoses present (1000) proeminent central necrosis - comedonecrosis (10) evident nucleoli
or or or
(1) mitoses absent (10) any confluent necrosis (2) nucleoli insignificant
  or or
(100) no true polarization of the cells with orientation toward a lumen (1) no necrosis (1) no nucleoli
or   
(10) polarization present but not pronouced   (10) present mitoses
or   or
(1) all the cells have a well-defined apex and show polarization   (1) absent